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General NPI Number Information
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NPI Number | 1447406434
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Entity Type | Organization
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Legal Business Name | ONEIL CULVER INC
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Dates
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Enumeration Date | 08/11/2008
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Last Update Date | 08/11/2008
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Provider Practice Location Address
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Address Line | 7183 JONESBORO RD # 1
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City | MORROW
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State | GA
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Zip | 30260-2940
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Country | US
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Telephone | 229-209-1322
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Fax |
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Provider Business Mailing Address
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Address Line | 7183 JONESBORO RD # 1
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City | MORROW
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State | GA
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Zip | 30260-2940
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Country | US
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Telephone | 229-209-1322
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ONEIL CULVER
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Credential |
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Telephone | 229-209-1322
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 048052
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License Number State | GA
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